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Epilepsy
"Epilepsy is a group of neurological {divergences} characterized by epileptic seizures."https://en.wikipedia.org/wiki/Epilepsy "As of 2015 about 39 million people have epilepsy.GBD 2015 Disease and Injury Incidence and Prevalence Collaborators (8 October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015.". Lancet. 388 (10053): 1545–1602. PMC 5055577 . PMID 27733282. doi:10.1016/S0140-6736(16)31678-6. Nearly 80% of cases occur in the developing world."Epilepsy Fact sheet". WHO. February 2016. Archivedfrom the original on 11 March 2016. Retrieved 4 March2016. In 2015 it resulted in 125,000 deaths up from 112,000 deaths in 1990.GBD 2015 Mortality and Causes of Death Collaborators (8 October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015.". Lancet. 388 (10053): 1459–1544. PMID 27733281. doi:10.1016/s0140-6736(16)31012-1.GBD 2013 Mortality and Causes of Death, Collaborators (17 December 2014). "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.". Lancet. 385 (9963): 117–71. PMC 4340604 . PMID 25530442. doi:10.1016/S0140-6736(14)61682-2. Epilepsy is more common in older people.Brodie, MJ; Elder, AT; Kwan, P (November 2009). "Epilepsy in later life". Lancet neurology. 8''' (11): 1019–30. PMID 19800848. doi:10.1016/S1474-4422(09)70240-6.Holmes, Thomas R. Browne, Gregory L. (2008). Handbook of epilepsy (4th ed.). Philadelphia: Lippincott Williams & Wilkins. p. 7. ISBN 978-0-7817-7397-3. Archived from the original on 29 May 2016. In the developed world, onset of new cases occurs most frequently in babies and the elderly." Causes Epilepsy has no single known cause, hence is not specifically a 'disease' but a general group of related divergences all characterized by epileptic seizures. The onset of such seizures can occur as a direct result of an injury or brain disease, or they can be present in early childhood. Due to these variations, it's hard to define any one cause for epilepsy. Is Epilepsy a D--ease of Synaptic Transmission? - Epilepsy Currents (TW: refers to epilepsy as a disease) By Jaideep Kapur, MD, PhD, September 8, 2005 "Much work has been done in the past 3 decades to support the notion that seizures and interictal spikes result from the combined action of networks of neurons. Alterations in synaptic transmission appear to play a critical role in generating this network activity." "Thus, there exist two kinds of ion channel mutations in humans—each having an opposite effect on synaptic transmission, yet both leading to epilepsy. Glasscok et al. reasoned that if both these mutations were present in a single animal they would cancel out each other's effect. In a series of carefully performed experiments, the investigators demonstrate that the presence of both mutations (i.e., double homozygous) in a single transgenic mouse results in reduced seizures, decreased mortality, and increased long-term survival. In addition, there was marked reduction in seizure activity compared with single homozygous mice, including marked attenuation of spike-wave seizures and diminished frequency and intensity of generalized tonic–clonic seizures." Is epilepsy a progressive d--ease? The neurobiological consequences of epilepsy. - Epilepsia By AJ Cole, 2000 "While primary, or idiopathic, epilepsies may exist, in the vast majority of cases epilepsy is a symptom of an underlying brain disease or injury. In these cases, it is difficult if not impossible to dissociate the consequences of epilepsy from the consequences of the underlying disease, the treatment of either the disease or the epilepsy, or the actual seizures themselves. Several cases of apparent complications of epilepsy are presented to illustrate the range of consequences encountered in clinical practice and the difficulty in assigning blame for progressive symptomatology in individual cases. Because of the difficulty in interpreting clinical material, many investigators have turned to epilepsy models in order to address the potential progressive consequences of recurrent seizures. The authors review experimental data, mainly from animal models, that illustrate short-, medium-, and long-term morphological and biochemical changes in the brain occurring after seizures, and attempt to relate these observations to the human condition." Demographics The fact that nearly 80% of cases of epilepsy come from the developing world (where under-diagnosis is usually the norm), suggests strongly that epilepsy is a divergence strongly linked to poverty. Links with Autism suggest that Autism may too be much more common in the developing world and in working class people generally, but since Autism requires much more subtle (and expensive) steps to achieve diagnosis, working class Autism is 'swept under the rug', so to speak. Some countries in the developing world have been reported to have rates of epilepsy as high as 5.7%https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2393447/. Incidence of epilepsy - Neurology By A.K. Ngugi, MSc, et. al., September 6, 2011 "Thirty-three articles met the entry criteria. The median incidence of epilepsy was 50.4/100,000/year (interquartile range IQR 33.6–75.6), while it was 45.0 (IQR 30.3–66.7) for high-income countries and 81.7 (IQR 28.0–239.5) for low- and middle-income countries." Comorbidity (see also Autism Comorbidities) Epilepsy is highly comorbid with several other divergences, including autism. Autism Overall prevalence of epilepsy is about 0.05%https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3171955/, meanwhile the prevalence of epilepsy in Autistic populations is up to 40%Autism and epilepsy: Cause, consequence, comorbidity, or coincidence? (with other studies varying from 16-54%)Autism Spectrum Disorder and Epilepsy: disorders with a shared biology . According to Bayes' Theorem, the probability of an event 'A', given a coincidental event 'B' is given by: P(A|B)=P(B|A)\frac {P(A)}{P(B)} where P(B|A) is the probability of the event 'B', assuming that 'A' has occurred, and P(A) and P(B) are the absolute probabilities of the respective events. Allowing 'A' to be the incidence of Autism in an individual, and 'B' to be the incidence of epilepsy, then we have P(A) = 1/68https://www.cdc.gov/ncbddd/autism/data.html and P(B)=0.0005. The Autistic prevalence of epilepsy, P(B|A) is then about 40%, P(B|A)=0.4. From this we can roughly extrapolate these data to give the likelihood of being Autistic, given that an individual is known to have epilepsy: P(A|B)=0.4\cdot\frac{0.0147}{0.0005}\approx 0.294 Hence, about 29.4% of people with epilepsy can be expected to be Autistic, assuming these data are all compatible. Hence, having epilepsy means it is about 20 times more likely that a person is Autistic, compared to the general population. '''Side note: if this proportion is applicable for epilepsy elsewhere in the world, then in countries where epilepsy is much more prevalent, such as the 5.7% seen in some studies, then this implies a higher rate of autism also. Famous Examples "Hugo Weaving, Sir Isaac Newton, Vincent Van Gogh, Napoleon Bonaparte, Neil Young, Charles Dickens, Agatha Christie, Danny Glover, Alexander the Great, Michelangelo, Alfred Nobel, Julius Caesar, Leonardo Da Vinci, Aristotle, Edgar Allen Poe, Alfred the Great, Theodore Roosevelt, Lewis Carrol, Bud Abbott, George Frederick Handel, Richard Burton, Charles V of Spain, Fyodor Dostoyevsky, Hannibal, Pythagoras, James Madison, Lord Byron, Martin Luther, Peter Tchaikovsky, Sir Walter Scott, Truman Capote, Socrates and Chanda Gunn."https://www.exploringlifesmysteries.com/famous-people-with-disabilities/ References Category:Disability Category:Neurology Category:Neuroscience